JPH0356068B2 - - Google Patents
Info
- Publication number
- JPH0356068B2 JPH0356068B2 JP61305385A JP30538586A JPH0356068B2 JP H0356068 B2 JPH0356068 B2 JP H0356068B2 JP 61305385 A JP61305385 A JP 61305385A JP 30538586 A JP30538586 A JP 30538586A JP H0356068 B2 JPH0356068 B2 JP H0356068B2
- Authority
- JP
- Japan
- Prior art keywords
- tube
- catheter
- flow path
- vasodilator
- pipe
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
- 229940124549 vasodilator Drugs 0.000 claims description 61
- 239000003071 vasodilator agent Substances 0.000 claims description 61
- 239000000853 adhesive Substances 0.000 claims description 6
- 230000001070 adhesive effect Effects 0.000 claims description 6
- 230000004927 fusion Effects 0.000 claims description 6
- 229920005992 thermoplastic resin Polymers 0.000 claims description 5
- 230000010339 dilation Effects 0.000 claims description 3
- 230000002792 vascular Effects 0.000 claims description 2
- 210000004204 blood vessel Anatomy 0.000 description 35
- 239000002872 contrast media Substances 0.000 description 21
- 238000002399 angioplasty Methods 0.000 description 13
- 208000031481 Pathologic Constriction Diseases 0.000 description 8
- 230000036262 stenosis Effects 0.000 description 8
- 208000037804 stenosis Diseases 0.000 description 8
- -1 polypropylene Polymers 0.000 description 7
- 230000006378 damage Effects 0.000 description 6
- 238000002347 injection Methods 0.000 description 6
- 239000007924 injection Substances 0.000 description 6
- 238000000034 method Methods 0.000 description 6
- 230000017531 blood circulation Effects 0.000 description 5
- 239000000463 material Substances 0.000 description 4
- 239000002184 metal Substances 0.000 description 4
- 239000004743 Polypropylene Substances 0.000 description 3
- 210000004369 blood Anatomy 0.000 description 3
- 239000008280 blood Substances 0.000 description 3
- 230000006866 deterioration Effects 0.000 description 3
- 230000003902 lesion Effects 0.000 description 3
- 229920001155 polypropylene Polymers 0.000 description 3
- 229920000181 Ethylene propylene rubber Polymers 0.000 description 2
- 210000001124 body fluid Anatomy 0.000 description 2
- 239000010839 body fluid Substances 0.000 description 2
- 238000012790 confirmation Methods 0.000 description 2
- 229920001577 copolymer Polymers 0.000 description 2
- 238000007599 discharging Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000002594 fluoroscopy Methods 0.000 description 2
- 210000005259 peripheral blood Anatomy 0.000 description 2
- 239000011886 peripheral blood Substances 0.000 description 2
- 230000002093 peripheral effect Effects 0.000 description 2
- 229920000915 polyvinyl chloride Polymers 0.000 description 2
- 239000004800 polyvinyl chloride Substances 0.000 description 2
- 229920002379 silicone rubber Polymers 0.000 description 2
- 239000004945 silicone rubber Substances 0.000 description 2
- 229920003051 synthetic elastomer Polymers 0.000 description 2
- 239000005061 synthetic rubber Substances 0.000 description 2
- 210000004026 tunica intima Anatomy 0.000 description 2
- KKJUPNGICOCCDW-UHFFFAOYSA-N 7-N,N-Dimethylamino-1,2,3,4,5-pentathiocyclooctane Chemical compound CN(C)C1CSSSSSC1 KKJUPNGICOCCDW-UHFFFAOYSA-N 0.000 description 1
- NIXOWILDQLNWCW-UHFFFAOYSA-M Acrylate Chemical compound [O-]C(=O)C=C NIXOWILDQLNWCW-UHFFFAOYSA-M 0.000 description 1
- 229920002153 Hydroxypropyl cellulose Polymers 0.000 description 1
- 239000004698 Polyethylene Substances 0.000 description 1
- 239000002202 Polyethylene glycol Substances 0.000 description 1
- 239000004793 Polystyrene Substances 0.000 description 1
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 1
- BZHJMEDXRYGGRV-UHFFFAOYSA-N Vinyl chloride Chemical compound ClC=C BZHJMEDXRYGGRV-UHFFFAOYSA-N 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 238000009530 blood pressure measurement Methods 0.000 description 1
- 239000011248 coating agent Substances 0.000 description 1
- 238000000576 coating method Methods 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 230000008602 contraction Effects 0.000 description 1
- 229940039231 contrast media Drugs 0.000 description 1
- 238000007887 coronary angioplasty Methods 0.000 description 1
- 210000004351 coronary vessel Anatomy 0.000 description 1
- 238000002316 cosmetic surgery Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 230000000916 dilatatory effect Effects 0.000 description 1
- 239000005038 ethylene vinyl acetate Substances 0.000 description 1
- 230000023597 hemostasis Effects 0.000 description 1
- 229920001477 hydrophilic polymer Polymers 0.000 description 1
- 239000001863 hydroxypropyl cellulose Substances 0.000 description 1
- 235000010977 hydroxypropyl cellulose Nutrition 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 239000003550 marker Substances 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 229920002401 polyacrylamide Polymers 0.000 description 1
- 229920000515 polycarbonate Polymers 0.000 description 1
- 239000004417 polycarbonate Substances 0.000 description 1
- 229920000573 polyethylene Polymers 0.000 description 1
- 229920001223 polyethylene glycol Polymers 0.000 description 1
- 229920002338 polyhydroxyethylmethacrylate Polymers 0.000 description 1
- 229920002223 polystyrene Polymers 0.000 description 1
- 229920000036 polyvinylpyrrolidone Polymers 0.000 description 1
- 239000001267 polyvinylpyrrolidone Substances 0.000 description 1
- 235000013855 polyvinylpyrrolidone Nutrition 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 239000011780 sodium chloride Substances 0.000 description 1
- 230000002966 stenotic effect Effects 0.000 description 1
- 210000005166 vasculature Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/104—Balloon catheters used for angioplasty
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M2025/0004—Catheters; Hollow probes having two or more concentrically arranged tubes for forming a concentric catheter system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
- A61M25/0026—Multi-lumen catheters with stationary elements
- A61M2025/0039—Multi-lumen catheters with stationary elements characterized by lumina being arranged coaxially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1006—Balloons formed between concentric tubes
Landscapes
- Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Anesthesiology (AREA)
- Child & Adolescent Psychology (AREA)
- Biophysics (AREA)
- Pulmonology (AREA)
- Engineering & Computer Science (AREA)
- Vascular Medicine (AREA)
- Biomedical Technology (AREA)
- Hematology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Description
【発明の詳細な説明】
（産業上の利用分野）
本発明は、血管拡張カテーテルに関するもので
ある。詳しく述べると本発明は、血管内狭窄部を
拡張治療し、未梢側血流を改善するための血管拡
張カテーテルに関するものである。DETAILED DESCRIPTION OF THE INVENTION (Industrial Field of Application) The present invention relates to a vasodilator catheter. Specifically, the present invention relates to a blood vessel dilation catheter for dilating and treating an intravascular stenosis and improving peripheral blood flow.
（従来の技術）
血管などの脈管における狭窄ないし閉塞が起つ
た場合、脈管の狭窄ないしは閉塞部を開大ないし
は再疎通し、脈管未梢側の体液流の改善を図るた
めに脈管形成術（PTA：Percutaneous
Transluminal Angioplasy；PTCA：
Percutaneous Transluminal Coronary
Angioplasty等）が行なわれる。この脈管形成術
は、例えば、まず経皮的に血管を確保した後、管
部に細いガイドワイヤーを通し、このガイドワイ
ヤーを案内として、先端部に拡張体（バルーン）
を有するカテーテルを挿入し、この拡張体を狭窄
ないしは閉塞を起こしている患部に位置させ、引
き続きこの拡張体に末端ハブより液体（例えば造
影剤または生理食塩水など）を加圧（数気圧から
10気圧程度）注入し、拡張体を血管内壁に向つて
膨張させ、狭窄ないし閉塞部を圧縮・拡大するこ
とで行なわれる。(Prior art) When stenosis or occlusion occurs in a vessel such as a blood vessel, the vasculature is opened or recanalized to open or recanalize the stenosis or occlusion of the vessel, and to improve the flow of body fluids on the peripheral side of the vessel. Plastic surgery (PTA: Percutaneous
Transluminal Angioplasty; PTCA:
Percutaneous Transluminal Coronary
Angioplasty etc.) are performed. In this angioplasty procedure, for example, first a blood vessel is secured percutaneously, then a thin guide wire is passed through the tube, and an expansion body (balloon) is placed at the tip using this guide wire as a guide.
Insert a catheter with a stenosis or occlusion, position this dilator in the area of stenosis or occlusion, and then pressurize the dilator with a liquid (e.g., contrast agent or saline) (from several atmospheres to
This is done by injecting 10 atm (approx.
このような脈管形成術において用いられる血管
拡張カテーテルとしては、従来グリユンテイツヒ
［Gruntzig］タイプおよびシンプソン−ロバート
［Simpson−Robert］タイプのものが主流であ
る。グリユンテイツヒタイプのものは、２つの管
腔を有するカテーテルチユーブの先端近傍に拡張
体を所持しており、この２つの管腔の一方は先端
で開放されて、ガイドワイヤーおよび先端圧測定
用の通路を形成しており、他方の管腔は拡張体基
端側で拡張体へと連通されて、造影剤等を加圧注
入し、拡張体を膨張させるための流路を形成して
なるものである。またシンプソン−ロバートタイ
プのものは、先端で開放され、第１の流路を形成
する内管と、その内管を囲繞して内管との間に第
２の流路を形成しかつ先端部に拡張体を合わても
つた外管とよりなる同軸的二重管構造を有してい
る。更に第２の流路中には気泡除去用に極細の金
属製パイプが配されている。従つてこのタイプは
第２の流路を通して造影剤等を拡張体に注入し、
残存空気を金属製パイプにより除去した後、脈管
形成術に用いられる。 Conventionally, the Gruntzig type and the Simpson-Robert type are the main types of vasodilator catheters used in such angioplasty. The Griunteitzch type has an expander near the tip of a catheter tube that has two lumens, one of which is open at the tip and used for guide wire and tip pressure measurement. The other lumen is connected to the expansion body at the proximal end of the expansion body to form a flow path for pressurized injection of a contrast agent, etc., to inflate the expansion body. It is something. The Simpson-Robert type has an inner tube that is open at the tip and forms a first flow path, and a second flow path that surrounds the inner tube and forms a second flow path between the inner tube and the tip. It has a coaxial double tube structure consisting of an outer tube with an extension body. Furthermore, an extremely thin metal pipe is arranged in the second flow path for removing air bubbles. Therefore, in this type, a contrast agent, etc. is injected into the expansion body through the second flow path,
After removing residual air with a metal pipe, it is used for angioplasty.
（発明が解決しようとする問題点）
しかしながらグリユンテイツヒタイプのもの
は、造影剤等を加圧注入し、拡張体を膨張させた
際に拡張体内に存在する気泡の除去操作が煩雑化
し、また完全に気泡を除去することが困難である
ために造影性の低下をきたし拡張体の位置および
形態の確認が十分に行なえず脈管形成術の完全な
施行を阻害するものとなつていた。さらに２つの
管腔を有するカテーテルチユーブ構造により、カ
テーテルの柔軟性が失われ、屈曲の激しい血管に
おいては血管内壁を損傷する虞れのあるものであ
つた。(Problems to be Solved by the Invention) However, with the Gryunteitzch type, when a contrast medium or the like is injected under pressure and the expandable body is inflated, the operation for removing air bubbles existing inside the expandable body becomes complicated. Furthermore, since it is difficult to completely remove air bubbles, contrast performance deteriorates, and the position and shape of the expanded body cannot be sufficiently confirmed, which obstructs the complete implementation of angioplasty. Furthermore, due to the catheter tube structure having two lumens, the flexibility of the catheter is lost, and there is a risk of damaging the inner wall of the blood vessel in a blood vessel with severe curvature.
またシンプソン−ロバートタイプのものは、気
泡除去用の金属製パイプを有するためにカテーテ
ルの柔軟性が失われ、グリユンテイツヒタイプの
ものと同様に、屈曲の激しい血管においては血管
の内壁を損傷する虞れ、さらには金属製パイプが
カテーテルを突き破る可能性を有しているもので
あつた。 In addition, the Simpson-Robert type catheter loses its flexibility because it has a metal pipe for removing air bubbles, and like the Gryunteizg type catheter, it can damage the inner wall of a blood vessel with severe bends. Furthermore, there was a possibility that the metal pipe could pierce the catheter.
したがつて、本発明は、新規な血管拡張カテー
テルを提供することを目的とする。本発明はまた
拡張体内の残存空気を容易に除去でき、これによ
り気泡混入による造影性の低下を防止し、血管内
での拡張体の位置および形態の確認を容易とする
血管拡張カテーテルを提供することを目的とす
る。本発明はさらに血管内壁の損傷を抑制し、血
管内膜剥離等の合併症を低減することのできる血
管拡張カテーテルを提供することを目的とする。 It is therefore an object of the present invention to provide a novel vasodilator catheter. The present invention also provides a blood vessel dilation catheter that can easily remove residual air within the expandable body, thereby preventing deterioration of contrast quality due to inclusion of air bubbles, and facilitating confirmation of the position and shape of the expandable body within the blood vessel. The purpose is to A further object of the present invention is to provide a vasodilator catheter that can suppress damage to the inner wall of a blood vessel and reduce complications such as avulsion of the vascular intima.
（発明が解決しようとする問題点）
上記諸目的は、先端の開放された第１流路を形
成する内管、該内管を囲繞して該内管との間に第
２流路を形成する中管、および該中管を囲繞して
該中管との間に第３流路を形成する外管から構成
される三重管型カテーテルチユーブと、該カテー
テルチユーブの先端近傍において第２流路および
第３流路のそれぞれの開口部を内包して該カテー
テルチユーブの外周に取付けられ、第２流路およ
び第３流路に連通する空間を形成する少なくとも
一部が円筒状で折り畳み可能な拡張体と、該カテ
ーテルチユーブの基端に取付けられ、第２流路の
開口部が拡張体のカテーテルチユーブ先端側端部
近傍に、また第３流路の開口部が拡張体のカテー
テルチユーブ基端側端部近傍にそれぞれ設けられ
ており、３つの流路にそれぞれ連通する３つのポ
ートを備えてなる三方アダプターとからなること
を特徴とする血管拡張カテーテルにより達成され
る。本発明はまた、中管の内周面には、内管の外
周面に接する少なくとも１つ以上の突起を設けた
ことを特徴とする血管拡張カテーテルを示すもの
である。本発明はまた中管の先端は、内管外径と
同等もしくは若干小径にテーパー加工されて内管
に嵌合し接着剤あるいは熱融着により固着され、
第２流路が中管の先端部近傍に設けられた少なく
とも１個の側孔を介して拡張体と連通することを
特徴とする血管拡張カテーテルを示すものであ
る。本発明はさらに外管の先端は、中管外径と同
等もしくは若干小径にテーパー加工されて中管に
嵌合し接着剤あるいは熱融着により固着され、第
３流路が外管の先端部近傍に設けられた少なくと
も１個の側孔を介して拡張体と連通することを特
徴とする血管拡張カテーテルを示すものである。
本発明はさらにまた三重管型カテーテルチユーブ
の内管、中管および外管がそれぞれ同軸的に配さ
れたものである血管拡張カテーテルを示すもので
ある。本発明はまた、三重管型カテーテルチユー
ブおよび拡張体が熱可塑性樹脂により構成される
ものである血管拡張カテーテルを示すものであ
る。本発明はさらに拡張体の硬度が、三重管型カ
テーテルチユーブの硬度よりも小さいものである
血管拡張カテーテルを示すものである。本発明は
また、外管外面、拡張体外面および内管内面には
親水化処理が施されているものである血管拡張カ
テーテルを示すものである。(Problems to be Solved by the Invention) The above objects include an inner tube that forms a first flow path with an open tip, and a second flow path that surrounds the inner tube and forms a second flow path between the inner tube and the inner tube. A triple-pipe catheter tube consisting of a middle tube that surrounds the middle tube and an outer tube that forms a third flow path between the middle tube and the middle tube, and a second flow path near the tip of the catheter tube. and a collapsible extension that is at least partially cylindrical and is attached to the outer periphery of the catheter tube, enclosing each opening of the third flow path and forming a space that communicates with the second flow path and the third flow path. and a second passageway opening near the distal end of the catheter tube of the expansion body, and a third passageway opening near the proximal end of the catheter tube of the expansion body. This is achieved by a vasodilator catheter characterized in that it consists of a three-way adapter comprising three ports, each of which is provided near its end and communicates with each of the three flow channels. The present invention also provides a vasodilator catheter characterized in that the inner circumferential surface of the middle tube is provided with at least one protrusion that contacts the outer circumferential surface of the inner tube. The present invention also provides that the tip of the middle tube is tapered to a diameter equal to or slightly smaller than the outer diameter of the inner tube, and is fitted into the inner tube and fixed by adhesive or heat fusion,
This shows a vasodilator catheter characterized in that the second flow path communicates with the dilator through at least one side hole provided near the distal end of the middle tube. The present invention further provides that the tip of the outer tube is tapered to a diameter equal to or slightly smaller than the outer diameter of the middle tube, and is fitted into the middle tube and fixed by adhesive or heat fusion, and the third flow path is formed at the tip of the outer tube. This shows a vasodilator catheter characterized in that it communicates with the dilator through at least one side hole provided nearby.
The present invention further provides a vasodilator catheter in which the inner tube, middle tube, and outer tube of a triple-tube type catheter tube are arranged coaxially. The present invention also provides a vasodilator catheter in which the triple-tube catheter tube and the expander are constructed of thermoplastic resin. The present invention further provides a vasodilator catheter in which the hardness of the dilator is smaller than the hardness of the triple-tube catheter tube. The present invention also provides a vasodilator catheter in which the outer surface of the outer tube, the outer surface of the expanded body, and the inner surface of the inner tube are subjected to hydrophilic treatment.
（作用）
しかして本発明の血管拡張カテーテルにおい
て、カテーテルチユーブとして三重管型カテーテ
ルチユーブを用い、同チユーブにより形成される
３つの流路のうち、２つの流路を拡張体と連通さ
せたことを最大の特徴とするものである。これゆ
え本発明の血管拡張カテーテルにおいては、所定
部位に拡張体を配置し、この拡張体に末端アダプ
ターより造影剤等を注入して膨張させる際、拡張
体内に残存する空気は該拡張体に連通する一方の
流路より造影剤が拡張体内に進入するに従つて、
該拡張体に連通する他方の流路より容易に排除さ
れることができる。従つて、拡張体内における気
泡混入における造影性の低下が防止され、血管内
での拡張体の位置および形態の確認が容易とな
る。ひいては脈管形成術をより確実かつ容易なも
のとして、該形成術における血管内壁の損傷を抑
制し、血管内膜剥離等の合併症を低減することの
できるものである。また、本発明の血管拡張カテ
ーテルにおいては、上記のように気泡除去用の流
路を三重管型カテーテルチユーブにより形成され
る流路の１つにより構成するために、血管拡張カ
テーテルは柔軟性を失わず、屈曲の激しい血管に
おいて使用されても血管内壁を損傷することのな
いものである。(Function) In the vasodilator catheter of the present invention, a triple-pipe catheter tube is used as the catheter tube, and two of the three flow paths formed by the tube are communicated with the expansion body. This is its biggest feature. Therefore, in the vasodilator catheter of the present invention, when the expandable body is placed at a predetermined site and the expandable body is injected with a contrast medium or the like from the terminal adapter to inflate, the air remaining in the expandable body is communicated with the expandable body. As the contrast agent enters the dilated body from one of the channels,
It can be easily removed from the other channel communicating with the expansion body. Therefore, deterioration in contrast performance due to the inclusion of air bubbles in the expanded body is prevented, and the position and shape of the expanded body within the blood vessel can be easily confirmed. Furthermore, it is possible to make angioplasty more reliable and easier, to suppress damage to the inner wall of the blood vessel during the angioplasty, and to reduce complications such as intimal detachment. Furthermore, in the vasodilator catheter of the present invention, since the flow path for removing air bubbles is constituted by one of the flow paths formed by the triple-pipe catheter tube as described above, the vasodilator catheter loses flexibility. First, it does not damage the inner wall of the blood vessel even if it is used in a blood vessel with severe curvature.
（実施例）
以下、本発明の血管拡張カテーテルを実施態様
に基づきより具体的に説明する。(Example) Hereinafter, the vasodilator catheter of the present invention will be described in more detail based on embodiments.
第１図〜第４図は、本発明に係わる血管拡張カ
テーテルの一実施例を示したものである。第１図
は、本実施例の基端側における構成を示す拡大断
面図であり、また第２〜４図は本実施例の先端側
における構成を示す拡大断面図である。 1 to 4 show an embodiment of a vasodilator catheter according to the present invention. FIG. 1 is an enlarged sectional view showing the structure of the present embodiment on the proximal end side, and FIGS. 2 to 4 are enlarged sectional views showing the structure of the present embodiment on the distal end side.
すなわち、本発明の血管拡張カテーテルは、第
１〜４図に示すように、先端の開放された第１流
路Ａを形成する内管１、該内管１を囲繞して該内
管１との間に第２流路Ｂを形成する中管２、およ
び該中管２を囲繞して該中管２との間に第３流路
Ｃを形成する外管３から構成される三重管型カテ
ーテルチユーブ４をカテーテルチユーブとして有
するものである。 That is, as shown in FIGS. 1 to 4, the vasodilator catheter of the present invention includes an inner tube 1 forming a first flow path A with an open tip, and an inner tube 1 surrounding the inner tube 1. A triple-pipe type consisting of a middle pipe 2 forming a second flow path B between the two, and an outer pipe 3 surrounding the middle pipe 2 and forming a third flow path C between the middle pipe 2 and the middle pipe 2. It has a catheter tube 4 as a catheter tube.
本実施例において、第１流路Ａは血管拡張カテ
ーテル使用時における血液流路およびガイドワイ
ヤー通路として、第２流路Ｂは残留空気排出流路
として、また第３流路Ｃは造影剤等の充填流路と
して作用する。このため第２流路Ｂの流路面積
は、第３流路Ｃの流路面積に比較して小さいもの
として構成されることが望ましい。しかしながら
本発明の他の実施態様においては逆に、第２流路
Ｂを造影剤等の充填流路として、第３流路Ｃを残
留空気排出流路として構成することも可能であ
り、この実施態様においては第２流路Ｂの流路面
積は、第３流路Ｃの流路面積に比較して大きいも
のとして構成されることが望ましい。 In this example, the first flow path A is used as a blood flow path and a guide wire path when a vasodilator catheter is used, the second flow path B is used as a residual air discharge flow path, and the third flow path C is used as a flow path for discharging contrast media, etc. Acts as a filling channel. For this reason, it is desirable that the flow area of the second flow path B be smaller than that of the third flow path C. However, in other embodiments of the present invention, it is also possible to conversely configure the second flow path B as a flow path for filling a contrast agent, etc., and the third flow path C as a flow path for discharging residual air. In this embodiment, it is desirable that the second flow path B has a larger flow area than the third flow path C.
また本発明の血管拡張カテーテルにおいて、三
重管型カテーテルチユーブ４を構成する内管１、
中管２および外管３は、同軸的に配された円管で
あることが望ましいが各流路を十分に確保しかつ
該カテーテルチユーブの柔軟な屈曲性を阻害しな
い限りにおいてその構成は任意であり、例えば円
管である内管１および外管３の軸線と楕円管であ
る中管２の中心線を概略一致させた組合せなども
用いられ得る。 Further, in the vasodilator catheter of the present invention, the inner tube 1 constituting the triple-tube catheter tube 4;
The middle tube 2 and the outer tube 3 are preferably circular tubes arranged coaxially, but their configurations are arbitrary as long as each flow path is sufficiently secured and the flexible bendability of the catheter tube is not inhibited. For example, a combination in which the axes of the inner tube 1 and outer tube 3, which are circular tubes, and the center line of the middle tube 2, which is an elliptical tube, approximately coincide with each other, may also be used.
さらに、本実施例においては、残留空気排出流
路として作用する流路面積の小さい第２流路Ｂを
形成するために内管１の外径と中管２の内径が近
似のものとされており、内管１と中管２が密着し
て第２流路Ｂが閉塞していまうことを防止する意
味から、中管２の内周面には、内管の外周面に接
する突起５が設けられている。このような突起５
を形成する場合、突起５の数は軸断面において少
なくとも２つ以上、好ましくは２〜４つであり、
その形状は軸線方向に形成された棒状のもの、あ
るいは適当な間隔をおいて配置された点状のもの
などが用いられ得る。また突起５は内管１の外周
面に設けても同一効果が得られるのはもちろんで
ある。 Furthermore, in this embodiment, the outer diameter of the inner tube 1 and the inner diameter of the middle tube 2 are approximated in order to form a second flow path B with a small flow path area that acts as a residual air exhaust flow path. In order to prevent the inner tube 1 and the middle tube 2 from coming into close contact with each other and blocking the second flow path B, the inner circumferential surface of the middle tube 2 is provided with a protrusion 5 that contacts the outer circumferential surface of the inner tube. It is provided. Such a protrusion 5
When forming, the number of protrusions 5 is at least 2 or more, preferably 2 to 4 in the axial cross section,
The shape may be a rod-like shape formed in the axial direction, or a dot-like shape arranged at appropriate intervals. It goes without saying that the same effect can be obtained even if the projections 5 are provided on the outer peripheral surface of the inner tube 1.
さて、本発明の血管拡張カテーテルにおいて
は、上記のごとき構成を有する三重管型カテーテ
ルチユーブ４の基端には、第１図に示すように三
方アダプター６が取り付けられている。この三方
アダプター６の有する３つのポートは、それぞれ
三重管型カテーテルチユーブ４の構成する３つの
流路と連通しており、本実施例においては、三方
アダプター６のガイドワイヤーポート７は第１流
路Ａと、ベントポート８は第２流路Ｂと、またイ
ンジエクシヨンポート９は第３流路Ｃとそれぞれ
連通している。 Now, in the vasodilator catheter of the present invention, a three-way adapter 6 is attached to the proximal end of the triple-pipe catheter tube 4 having the above-mentioned configuration, as shown in FIG. The three ports of this three-way adapter 6 communicate with the three flow paths that constitute the triple-pipe catheter tube 4, respectively. In this embodiment, the guide wire port 7 of the three-way adapter 6 is connected to the first flow path. A, the vent port 8 communicates with the second channel B, and the injection port 9 communicates with the third channel C, respectively.
一方、本発明の血管拡張カテーテルの先端近傍
には、第２図および第４図に示すように膨張収縮
可能な拡張体１０が、三重管型カテーテルチユー
ブ４の外周に、好ましくは該カテーテルチユーブ
と同軸的な筒状部分を有して取付けられている。
しかして本発明の血管拡張カテーテルにおいて
は、拡張体１０は、必ず第２流路Ｂおよび第３流
路Ｃのそれぞれの開口部を内包し、第２流路Ｂお
よび第３流路Ｃに連通する閉鎖空間Ｄを形成する
ように構成されなければならない。例えば本実施
例においては、三重管型カテーテルチユーブ４の
先端付近構造が第２図に示すように、外管３の先
端は中管２と外径と同等もしくは若干小径となる
ようにテーパー加工されて中管２に嵌合し接着剤
あるいは熱融着により固着され、この外管３の先
端よりもさらに延長された中管２の先端も同様
に、内管１外径と同等もしくは若干小径となるよ
うにテーパー加工されて内管１に嵌合し接着剤あ
るいは熱融着により固着され、また外管３および
中管２がそれぞれ該固着部位よりも若干基端側に
少なくとも１個の側孔１１，１２を有するものと
されているゆえに、拡張体１０の一方の端部１３
を外管３の側孔１１よりも基端側において外管３
の外周に接着剤あるいは熱融着により固着し、拡
張体１０の他方の端部１４を中管２の側孔よりも
先端側において中管２あるいは内管１の外周に接
着剤あるいは熱融着により固着することで拡張体
１０を三重管型カテーテルチユーブの外周に取付
けている。なお、上記したごとく、拡張体１０
が、第２流路Ｂおよび第３流路Ｃのそれぞれの開
口部を内包し、第２流路Ｂおよび第３流路Ｃに連
通する閉鎖空間Ｄを形成するように構成されるも
のであれば、三重管型カテーテルチユーブ４の先
端近傍構造（中管２および外管３の開口部構造
等）および拡張体１０の接合構造は、本実施例に
例示されるものに限定されることなく、種々の変
更態様が適用できる。例えば、第５図〜第８図に
示される構造は、本発明の血管拡張カテーテルの
先端近傍構造として適用できるものである。なお
第５図〜第８図において表わされる各符号は、第
２図において表わされる同一符号の示す部位と同
じものを示すものであり、また第５図において符
号１１ａおよび１２ａは外管および中管の開口端
をそれぞれ示すものである。 On the other hand, near the tip of the vasodilator catheter of the present invention, as shown in FIGS. 2 and 4, an expandable body 10 that can be expanded and contracted is provided around the outer periphery of the triple-pipe catheter tube 4, preferably with the catheter tube. It is attached with a coaxial cylindrical part.
Therefore, in the vasodilator catheter of the present invention, the expansion body 10 necessarily includes the openings of the second flow path B and the third flow path C, and communicates with the second flow path B and the third flow path C. It must be constructed so as to form a closed space D in which For example, in this embodiment, as shown in FIG. 2, the structure near the tip of the triple-pipe catheter tube 4 is tapered so that the tip of the outer tube 3 has an outer diameter equal to or slightly smaller than that of the middle tube 2. Similarly, the tip of the middle tube 2, which is fitted into the middle tube 2 and fixed by adhesive or heat fusion, and which is further extended than the tip of the outer tube 3, has an outer diameter equal to or slightly smaller than the outer diameter of the inner tube 1. The outer tube 3 and the middle tube 2 each have at least one side hole slightly closer to the proximal end than the fixing part. 11 and 12, one end 13 of the expansion body 10
the outer tube 3 at the proximal end side of the side hole 11 of the outer tube 3.
The other end 14 of the expansion body 10 is fixed to the outer periphery of the middle tube 2 or the inner tube 1 with adhesive or heat fusion at the tip side of the side hole of the middle tube 2. The expansion body 10 is attached to the outer periphery of the triple-pipe catheter tube by fixing the expansion body 10 to the outer periphery of the triple-pipe catheter tube. In addition, as mentioned above, the extension body 10
is configured to include the respective openings of the second flow path B and the third flow path C and form a closed space D that communicates with the second flow path B and the third flow path C. For example, the structure near the tip of the triple-pipe catheter tube 4 (the opening structure of the middle tube 2 and the outer tube 3, etc.) and the joining structure of the expansion body 10 are not limited to those illustrated in this embodiment, Various modifications can be applied. For example, the structures shown in FIGS. 5 to 8 can be applied as the structure near the tip of the vasodilator catheter of the present invention. Each reference numeral shown in FIGS. 5 to 8 indicates the same part as the same reference numeral shown in FIG. 2, and in FIG. The opening ends of each are shown.
また本発明の血管拡張カテーテルにおいて、上
記のごとく拡張体１０に内包される第２流路Ｂお
よび第３流路Ｃの開口部（側孔１１，１２あるい
は開口端１１ａ，１２ａ）の配置は、第２図、第
５図〜第７図に示される実施態様におけるよう
に、拡張体の一端部１３近傍にいずれか一方の流
路の開口部を、また拡張体の他端部１４近傍に他
方の流路の開口部を有するように構成すること
が、拡張体１０内に残存する空気の排除を造影剤
等の注入によつて効率よく行なうために望ましい
ものであり、さらに第２流路Ｂおよび第３流路Ｃ
を形成する三重管型カテーテルチユーブの構造か
ら見て、拡張体１０のカテーテルチユーブ基端側
端部１３近傍に第３流路Ｃの開口部（側孔１１ま
たは開口端１１ａ）を、また拡張体１０のカテー
テルチユーブ先端側端部１４近傍に第２流路Ｂの
開口部（側孔１２または開口端１２ａ）を有する
ことがより容易に形成可能であることからより望
ましいものである。 Further, in the vasodilator catheter of the present invention, the arrangement of the openings (side holes 11, 12 or open ends 11a, 12a) of the second flow path B and third flow path C included in the expansion body 10 as described above is as follows: As in the embodiments shown in FIGS. 2 and 5 to 7, one of the channel openings is provided near one end 13 of the expandable body, and the other channel is provided near the other end 14 of the expandable body. In order to efficiently eliminate air remaining in the expansion body 10 by injecting a contrast medium or the like, it is preferable to configure the second flow path to have an opening. and third flow path C
Viewed from the structure of the triple-pipe catheter tube forming the catheter tube, the opening of the third flow path C (side hole 11 or opening end 11a) is located near the proximal end 13 of the catheter tube of the expansion body 10, and the expansion body It is more desirable to have the opening of the second flow path B (the side hole 12 or the open end 12a) near the distal end 14 of the catheter tube 10 because it can be formed more easily.
さらに、第１図〜第４図において示される本実
施例の血管拡張カテーテルにおいては、Ｘ線不透
過性のマーカー１５が、拡張体１０内において、
中管２の側孔１２の基端側近傍と、中管２の外管
３と密着部の先端側近傍の２ケ所で、中管２に、
接着或いはかしめてあり、Ｘ線透視下で拡張体１
０の位置の確認を可能とされている。 Furthermore, in the vasodilator catheter of this embodiment shown in FIGS.
In the middle tube 2 at two places, near the proximal end of the side hole 12 of the middle tube 2 and near the distal end of the part of the middle tube 2 that comes into close contact with the outer tube 3,
It is glued or caulked, and the expansion body 1 is inspected under X-ray fluoroscopy.
It is possible to confirm the position of 0.
本発明の拡張カテーテルは上記したような構造
を有するものであるが、その材質としては、内管
１、中管２および外管３からなる三重管型カテー
テルチユーブには、例えばポリ塩化ビニル、ポリ
プロピレン、ポリエチレン、エチレン−酢酸ビニ
ル共重合体等の軟質熱可塑性樹脂あるいはエチレ
ン−プロピレンゴム、シリコーンゴム等の合成ゴ
ムが用いられ、また拡張体１０には予めブロー成
形などにより成形さた薄肉の軟質ポリ塩化ビニ
ル、ポリプロピレン、ポリエチレン、エチレン−
酢酸ビニル共重合体等の軟質熱可塑性樹脂あるい
はエチレン−プロピレンゴム、シリコーンゴム等
の合成ゴムが用いられさらに三方アダプターには
ポリ塩化ビニル、ポリプロピレン、ポリスチレ
ン、ポリカーボネート等の熱可塑性樹脂が用いら
れる。また、拡張体１０を構成する材質として
は、拡張体を目的部位へ導入する際、拡張体は中
管１２に巻くように折り畳んで押し進めるため、
血管内に挿通された際折り畳まれた拡張体より血
管内壁を損傷することがないよう又、簡単に折り
畳めるように、三重管型カテーテルチユーブを構
成する材質より硬度の小さいものであることが望
ましい。さらに本発明の血管拡張カテーテルにお
いて、使用時に体液あるいは血管組成に接触する
虞れのある部位、すなわち、中管３の外面、拡張
体１０の外面および内管１の内面は、血液等との
接触に対し潤滑性を呈し、よりスムーズが血管内
挿通を期待するために、好ましくは親水化処理を
施されていることが望ましい。このような親水化
処理としては、例えばポリ（２−ヒドロキシエチ
ルメタクリレート）、ポリヒドロキシエチルアク
リレート、ヒドロキシプロピルセルロース、メチ
ルビニルエーテル無水マレイン酸共重合体、ポリ
エチレングリコール、ポリアクリルアミド、ポリ
ビニルピロリドン等の親水性ポリマーをコーテイ
ングする方法などが挙げられる。 The dilatation catheter of the present invention has the above-described structure, and the triple-tube catheter tube consisting of the inner tube 1, middle tube 2, and outer tube 3 is made of materials such as polyvinyl chloride and polypropylene. , a soft thermoplastic resin such as polyethylene, ethylene-vinyl acetate copolymer, or a synthetic rubber such as ethylene-propylene rubber or silicone rubber. Vinyl chloride, polypropylene, polyethylene, ethylene-
A soft thermoplastic resin such as vinyl acetate copolymer or a synthetic rubber such as ethylene-propylene rubber or silicone rubber is used, and a thermoplastic resin such as polyvinyl chloride, polypropylene, polystyrene, or polycarbonate is used for the three-way adapter. In addition, the material constituting the expansion body 10 is such that when introducing the expansion body to the target site, the expansion body is folded so as to wrap around the middle tube 12 and pushed forward.
It is desirable that the material is less hard than the material constituting the triple-pipe catheter tube so that the folded expansion body does not damage the inner wall of the blood vessel when inserted into the blood vessel, and so that it can be easily folded. Furthermore, in the vasodilator catheter of the present invention, parts that may come into contact with body fluids or blood vessel composition during use, that is, the outer surface of the middle tube 3, the outer surface of the expansion body 10, and the inner surface of the inner tube 1, are not in contact with blood or the like. It is preferable that the tube be hydrophilized so that it exhibits lubricity and can be inserted smoothly into the blood vessel. Such hydrophilic treatment includes, for example, hydrophilic polymers such as poly(2-hydroxyethyl methacrylate), polyhydroxyethyl acrylate, hydroxypropyl cellulose, methyl vinyl ether maleic anhydride copolymer, polyethylene glycol, polyacrylamide, and polyvinylpyrrolidone. Examples include a method of coating.
次に本発明の血管拡張カテーテルの脈管形成術
における使用方法を第１図〜第４図に示した実施
例の場合を例にとり説明する。 Next, a method of using the vasodilator catheter of the present invention in angioplasty will be described using the embodiment shown in FIGS. 1 to 4 as an example.
まず脈管形成術に先だち、血管拡張カテーテル
内の空気を除去する必要がある。本実施例の血管
拡張カテーテルの場合、血管拡張カテーテルの先
端側を上方に向けた状態で、インジエクシヨンポ
ート９より造影剤を注入し挿通する第３流路Ｃを
通して側孔１１より拡張体１０の内部空間Ｄへと
導く。拡張体１０内は、カテーテルチユーブ４の
基端側から造影剤により満たされ、拡張体１０内
の空気は造影剤の充填に従い、側孔１２より第２
流路Ｂを通じて排出され、ベントポート８より外
部へ放出される。拡張体１０の閉鎖空間Ｄが完全
に造影剤にて満たされたならば、オーバーフロー
した造影剤が更に側孔１２より第２流路Ｂを通じ
て排出され、ベントポート８より外部へ放出され
る。これにより血管拡張カテーテル内の空気の除
去およびその確認ができる。最後にベントポート
８より造影剤が放出され始めたら造影剤の注入を
止めベントポート８を栓子（図示せず）で閉じた
後、内部空間Ｄに残る不必要な造影剤をシリンジ
（図示せず）を用いて吸引排出して拡張体１０を
中管１０に巻くようにして拡張体部分の外径を小
さくできるようにし、血管形成術における血管挿
通に備える。 First, prior to angioplasty, it is necessary to remove the air within the vasodilator catheter. In the case of the vasodilator catheter of this embodiment, with the distal end of the vasodilator catheter facing upward, the contrast agent is injected through the injection port 9 and passed through the third passage C through the side hole 11 to the dilator 10. It leads to the internal space D of. The inside of the expansion body 10 is filled with a contrast medium from the proximal end side of the catheter tube 4, and the air inside the expansion body 10 is filled with the contrast medium from the side hole 12 to the second
It is discharged through the flow path B and is discharged to the outside from the vent port 8. When the closed space D of the expansion body 10 is completely filled with the contrast medium, the overflowing contrast medium is further discharged from the side hole 12 through the second channel B, and is discharged to the outside from the vent port 8. This allows the removal of air within the vasodilator catheter and its confirmation. Finally, when the contrast medium starts to be released from the vent port 8, the injection of the contrast medium is stopped and the vent port 8 is closed with an obturator (not shown). The expandable body 10 is wound around the middle tube 10 by suction and evacuation using the tube 1), thereby making it possible to reduce the outer diameter of the expandable body portion, in preparation for blood vessel insertion in angioplasty.
血管形成術はまず、第９図に示すように、患者
に対してセルジンガー法等により血管１６を確保
した後、ガイドカテーテル用ガイドワイヤー（図
示せず）を血管内に留置し、それに沿つてガイド
カテーテル１７を血管１６に挿入し、目的病変部
を有する冠状動脈入口に留置し、ガイドワイヤー
（図示せず）を抜去する。次に血管拡張カテーテ
ル１８のガイドワイヤーポート７より血管拡張カ
テーテル用ガイドワイヤー１９を三重管型カテー
テルチユーブ４の内管１内に挿入し、内管１の先
端開口部２０より数cm出した状態とし、これを、
ガイドカテーテル１７を基端に接続されたＹ型コ
ネクター２１を介してガイドカテーテル１７内に
挿入する。第１０図は血管内におけるガイドカテ
ーテル１７および血管拡張カテーテル１８の状態
を示すものである。血管１６内において、ガイド
カテーテル１７内は先端より進入した血液により
満たされているが、血管拡張カテーテル１８の外
表面が上記したごとく親水化処理されていると血
液等の接触に対し潤滑性を呈し、血管拡張カテー
テル１８はガイドカテーテル１７内をスムーズに
進行する。血管拡張カテーテル１８はガイドカテ
ーテル１７の先端より目的病変部を有する血管内
に進入することとなる。続いて、血管拡張カテー
テル用ガイドワイヤー１９が第１１図に示すよう
に、目的病変部へと血管内を延長され、狭窄部２
２を通過後留置される。次に血管拡張カテーテル
１８を血管拡張カテーテル用ガイドワイヤー１９
に沿つて血管内を進行させる。この際血管壁２３
に血管拡張カテーテル１８が接触する虞れがある
が、血管拡張カテーテル１８の外表面が上記した
ごとく親水処理されていると潤滑性により血管壁
２３を損傷することなく進行させることができ
る。血管拡張カテーテル１８は、Ｘ線透視下で拡
張体１０内に配されたマーカー１５を目印とし
て、第１２図に示すように拡張体１０が狭窄部２
２に位置するまで進行させられ、この位置で留置
される。狭窄部２２に拡張体１０が到達したら、
インジエクシヨンポート９に接続されている脱気
された造影剤を充填した圧力計付インジエクター
２４で、数気圧から10気圧程度で加圧して造影剤
を拡張体１０内へ送り込み、第１３図に示すよう
に拡張体１０を膨張させ、狭窄部２２を圧縮し拡
大せしめる。この操作完了後、ガイドカテーテル
１７の基端に接続されたＹ型コネクター２１の造
影剤インジエクシヨンポート２５より造影剤を血
管内へ注入し、Ｘ線造影にて未梢側血流を観察す
る。血流改善が認められたら、血管内より血管拡
張カテーテル１８と血管拡張カテーテル用ガイド
ワイヤー１９を抜去し、さらにガイドカテーテル
１７を抜去した後、圧迫止血した手技を終える。 In the angioplasty procedure, as shown in FIG. 9, first, a blood vessel 16 is secured in the patient using the Seldinger method, etc., and then a guide wire for a guide catheter (not shown) is placed in the blood vessel, and a The guide catheter 17 is inserted into the blood vessel 16 and placed at the entrance of the coronary artery having the target lesion, and the guide wire (not shown) is removed. Next, the guide wire 19 for the vasodilator catheter is inserted into the inner tube 1 of the triple-tube catheter tube 4 through the guide wire port 7 of the vasodilator catheter 18, with the guide wire 19 protruding several centimeters from the distal end opening 20 of the inner tube 1. ,this,
The guide catheter 17 is inserted into the guide catheter 17 via the Y-shaped connector 21 connected to the proximal end. FIG. 10 shows the state of the guide catheter 17 and the vasodilator catheter 18 inside the blood vessel. In the blood vessel 16, the inside of the guide catheter 17 is filled with blood that enters from the tip, but if the outer surface of the vasodilator catheter 18 is hydrophilized as described above, it exhibits lubricity against contact with blood, etc. , the vasodilator catheter 18 advances smoothly within the guide catheter 17. The vasodilator catheter 18 enters the blood vessel containing the target lesion from the tip of the guide catheter 17. Subsequently, as shown in FIG. 11, the guide wire 19 for the vasodilator catheter is extended within the blood vessel to the target lesion area, and the stenotic area 2 is
After passing 2, the patient will be placed in detention. Next, the vasodilator catheter 18 is connected to the vasodilator catheter guide wire 19.
Proceed inside the blood vessel along the At this time, the blood vessel wall 23
However, if the outer surface of the vasodilator catheter 18 is hydrophilically treated as described above, it can be advanced without damaging the blood vessel wall 23 due to its lubricity. The vasodilator catheter 18 uses the marker 15 disposed inside the dilator 10 as a landmark under X-ray fluoroscopy, as shown in FIG.
It is advanced until it reaches position 2 and is left in place at this position. When the expansion body 10 reaches the stenosis 22,
An injector 24 with a pressure gauge, which is connected to the injection port 9 and filled with a degassed contrast medium, pressurizes the contrast medium from several atmospheres to about 10 atmospheres and sends the contrast medium into the expansion body 10, as shown in FIG. As shown, the expansion body 10 is expanded to compress and expand the narrowed portion 22. After completing this operation, a contrast medium is injected into the blood vessel through the contrast medium injection port 25 of the Y-shaped connector 21 connected to the proximal end of the guide catheter 17, and the peripheral blood flow is observed using X-ray contrast. . When the blood flow is improved, the vasodilator catheter 18 and the guide wire 19 for the vasodilator catheter are removed from the blood vessel, and the guide catheter 17 is further removed, and the procedure of compression hemostasis is completed.
（発明の効果）
以上述べたように本発明は、先端の開放された
第１流路を形成する内管、該内管を囲繞して該内
管との間に第２流路を形成する中管、および該中
管を囲繞して該中管との間に第３流路を形成する
外管から構成される三重管型カテーテルチユーブ
と、該カテーテルチユーブの先端近傍において第
２流路および第３流路のそれぞれの開口部を内包
して該カテーテルチユーブの外周に取付けられ、
第２流路および第３流路に連通する空間を形成す
る少なくとも一部が円筒状で折り畳み可能な拡張
体と、該カテーテルチユーブの基端に取付けら
れ、３つの流路にそれぞれ連通する３つのポート
を備えてなる三方アダプターとからなることを特
徴とする血管拡張カテーテルであるから、血管に
おいて狭窄ないし閉塞が起つた場合に、該狭窄な
いし閉塞部を開大ないし再疎通し、未梢側の血流
改善を図るために行なわれる脈管形成術において
好適に用いられることができるものである。特
に、拡張体内の残存空気を容易に除去できるため
に、気泡混入による造影性の低下が防止されて拡
張体の位置および形態の確認が容易となり、これ
によつてより正確な患部の処置が可能となり、ま
た血管過伸展による血管内膜損傷も防止できる。
さらに、気泡除去用の流路が三重管型カテーテル
チユーブにより形成される流路の１つにより構成
されるために、従来の血管拡張カテーテルと比較
してより柔軟な屈曲性を保持しているものであ
り、屈曲の激しい血管において使用されても血管
内壁を損傷する虞れは少ないものである。(Effects of the Invention) As described above, the present invention includes an inner tube that forms a first flow path with an open tip, and a second flow path that surrounds the inner tube and forms a second flow path between the inner tube and the inner tube. A triple-pipe catheter tube consisting of a middle tube, an outer tube surrounding the middle tube and forming a third flow path between the middle tube, and a second flow path near the tip of the catheter tube. attached to the outer periphery of the catheter tube, enclosing each opening of the third flow path;
a collapsible expander that is at least partially cylindrical and forms a space that communicates with the second flow path and the third flow path; Since the vasodilator catheter is characterized by comprising a three-way adapter equipped with a port, when stenosis or occlusion occurs in a blood vessel, it can open or recanalize the stenosis or occlusion, It can be suitably used in angioplasty performed to improve blood flow. In particular, since residual air inside the expansion body can be easily removed, deterioration of contrast quality due to air bubbles is prevented, making it easier to confirm the position and shape of the expansion body, which allows for more accurate treatment of the affected area. In addition, damage to the vascular intima due to vascular overstretching can be prevented.
Furthermore, because the air bubble removal flow path is formed by one of the flow paths formed by the triple-tube catheter tube, it maintains more flexible bendability compared to conventional vasodilator catheters. Therefore, there is little risk of damaging the inner wall of the blood vessel even if it is used in a blood vessel with severe curvature.
さらに本発明の血管拡張カテーテルにおいて、
第２流路の開口部が拡張体の一端部近傍に、また
第３流路の開口部が拡張体の他端部近傍にそれぞ
れ設けられている場合、より望ましくは第２流路
の開口部が拡張体のカテーテルチユーブ先端側端
部近傍に、また第３流路の開口部が拡張体のカテ
ーテルチユーブ基端側端部近傍にそれぞれ設けら
れているものである場合には、拡張体内に存在す
る空気の除去はより容易にかつ確実なものとな
り、また、中管の内周面に、内管の外周面に接す
る少なくとも１つ以上の突起を設け、さらに三重
管型カテーテルチユーブの内管、中管および外管
をそれぞれ同軸的に配すると三重管型カテーテル
チユーブにより形成される流路はより良好に形成
されるものとなり、また拡張体の硬度が三重管型
カテーテルチユーブの硬度よりも小さいものであ
ると拡張体の膨張収縮動作はより望ましいものと
なり、さらにまた外管外面、拡張体外面および内
管内面が親水化処理が施されているものであると
ガイドワイヤーおよび血管内における血管拡張カ
テーテルの進行がスムーズに行なえかつ接触した
血管内壁に損傷の起こる虞れも少なくなるものと
なるために、より一層優れた血管拡張カテーテル
として使用され得るものである。 Furthermore, in the vasodilator catheter of the present invention,
When the opening of the second flow path is provided near one end of the expansion body and the opening of the third flow path is provided near the other end of the expansion body, more preferably, the opening of the second flow path is provided near one end of the expansion body. is provided in the vicinity of the distal end of the catheter tube of the expandable body, and the opening of the third flow path is provided in the vicinity of the proximal end of the catheter tube of the expandable body. In addition, the inner circumferential surface of the middle tube is provided with at least one or more protrusions that contact the outer circumferential surface of the inner tube, and the inner tube of the triple tube type catheter tube, If the inner tube and outer tube are arranged coaxially, the flow path formed by the triple tube catheter tube will be better formed, and the hardness of the expansion body will be smaller than that of the triple tube catheter tube. If this is the case, the expansion and contraction operation of the expandable body will be more desirable, and if the outer surface of the outer tube, the outer surface of the expanded body, and the inner surface of the inner tube are subjected to hydrophilic treatment, it will be easier to use guide wires and vasodilator catheters in blood vessels. The catheter can be used as an even better vasodilator catheter because the catheter can advance smoothly and there is less risk of damaging the inner wall of the blood vessel it comes into contact with.
第１図は本発明の血管拡張カテーテルの一実施
例の基端部構造を示す拡大断面図、第２図は同実
施例の先端部構造を示す拡大断面図、第３図は第
２図の−断面図、第４図は第２図の−断
面図、第５図〜第７図はそれぞれ本発明の血管拡
張カテーテルの別の実施例の先端部構造を示す拡
大断面図、第８図は第７図の−断面図であ
り、また第９図〜第１３図は本発明の血管拡張カ
テーテルの一実施例の使用状態を示す模式図であ
る。
１……内管、２……中管、３……外管、４……
三重管型カテーテルチユーブ、６……三方アダプ
ター、１０……拡張体、１１，１２……側孔、１
１ａ，１２ａ……開口端、２０……先端開口部、
Ａ……第１流路、Ｂ……第２流路、Ｃ……第３流
路、Ｄ……閉塞空間。
FIG. 1 is an enlarged sectional view showing the proximal end structure of an embodiment of the vasodilator catheter of the present invention, FIG. 2 is an enlarged sectional view showing the distal end structure of the same embodiment, and FIG. 3 is the same as that of FIG. 4 is a sectional view of FIG. 2, FIGS. 5 to 7 are enlarged sectional views showing the tip structure of another embodiment of the vasodilator catheter of the present invention, and FIG. 7 is a sectional view taken along the line 7, and FIGS. 9 to 13 are schematic diagrams showing the state in which an embodiment of the vasodilator catheter of the present invention is used. 1... Inner tube, 2... Middle tube, 3... Outer tube, 4...
Triple tube type catheter tube, 6... Three-way adapter, 10... Expansion body, 11, 12... Side hole, 1
1a, 12a...opening end, 20...tip opening,
A...First channel, B...Second channel, C...Third channel, D...Closed space.
Claims (1)
該内管を囲繞して該内管との間に第２流路を形成
する中管、および該中管を囲繞して該中管との間
に第３流路を形成する外管から構成される三重管
型カテーテルチユーブと、該カテーテルチユーブ
の先端近傍において第２流路および第３流路のそ
れぞれの開口部を内包して該カテーテルチユーブ
の外周に取付けられ、第２流路および第３流路に
連通する空間を形成する少なくとも一部が円筒状
で折り畳み可能な拡張体と、該カテーテルチユー
ブの基端に取付けられ、第２流路の開口部が拡張
体のカテーテルチユーブ先端側端部近傍に、また
第３流路の開口部が拡張体のカテーテルチユーブ
基端側端部近傍にそれぞれ設けられており、３つ
の流路にそれぞれ連通する３つのポートを備えて
なる三方アダプターとからなることを特徴とする
血管拡張カテーテル。 ２ 中管の内周面には、内管の外周面に接する少
なくとも１つ以上の突起を設けたことを特徴とす
る特許請求の範囲第１項に記載の血管拡張カテー
テル。 ３ 中管の先端は、内管外径と同等もしくは若干
小径にテーパー加工されて内管に嵌合し接着剤あ
るいは熱融着により固着され、第２流路が中管の
先端部近傍に設けられた少なくとも１個の側孔を
介して拡張体と連通することを特徴とする特許請
求の範囲第１項または第２項に記載の血管拡張カ
テーテル。 ４ 外管の先端は、中管外径と同等もしくは若干
小径にテーパー加工されて中管に嵌合し接着剤あ
るいは熱融着により固着され、第３流路が外管の
先端部近傍に設けられた少なくとも１個の側孔を
介して拡張体と連通することを特徴とする特許請
求の範囲第１項〜第３項のいずれかに記載の血管
拡張カテーテル。 ５ 三重管型カテーテルチユーブの内管、中管お
よび外管がそれぞれ同軸的に配されたものである
特許請求の範囲第１項〜第４項のいずれかに記載
の血管拡張カテーテル。 ６ 三重管型カテーテルチユーブおよび拡張体が
熱可塑性樹脂により構成されるものである特許請
求の範囲第１項〜第５項のいずれかに記載の血管
拡張カテーテル。 ７ 拡張体の硬度が、三重管型カテーテルチユー
ブの硬度よりも小さいものである特許請求の範囲
第１項〜第６項のいずれかに記載の血管拡張カテ
ーテル。 ８ 外管外面、拡張体外面および内管内面には親
水化処理が施されているものである特許請求の範
囲第１項〜第７項のいずれかに記載の血管拡張カ
テーテル。[Scope of Claims] 1. An inner tube forming a first flow path with an open tip;
Consisting of a middle pipe that surrounds the inner pipe and forms a second flow path between the inner pipe and an outer pipe that surrounds the middle pipe and forms a third flow path between the inner pipe and the middle pipe. a triple-tube type catheter tube that is attached to the outer periphery of the catheter tube and includes openings of the second flow path and the third flow path near the distal end of the catheter tube; a collapsible expansion body having at least a partially cylindrical shape and forming a space communicating with the flow path, the expansion body being attached to the proximal end of the catheter tube, and having an opening for the second flow path at the distal end of the catheter tube of the expansion body; The opening of the third flow path is provided near the proximal end of the catheter tube of the expansion body, and a three-way adapter is provided with three ports communicating with the three flow paths, respectively. A vasodilator catheter characterized by: 2. The vasodilator catheter according to claim 1, wherein the inner circumferential surface of the inner tube is provided with at least one protrusion that contacts the outer circumferential surface of the inner tube. 3 The tip of the middle tube is tapered to a diameter equal to or slightly smaller than the outer diameter of the inner tube, fits into the inner tube, and is fixed with adhesive or heat fusion, and a second flow path is provided near the tip of the middle tube. The vasodilator catheter according to claim 1 or 2, wherein the catheter communicates with the dilator through at least one side hole. 4 The tip of the outer tube is tapered to a diameter equal to or slightly smaller than the outer diameter of the middle tube, fits into the middle tube, and is fixed with adhesive or heat fusion, and a third flow path is provided near the tip of the outer tube. The vasodilator catheter according to any one of claims 1 to 3, wherein the catheter communicates with the dilator through at least one side hole. 5. The vasodilator catheter according to any one of claims 1 to 4, wherein the inner tube, middle tube, and outer tube of the triple-tube catheter tube are arranged coaxially. 6. The vascular dilation catheter according to any one of claims 1 to 5, wherein the triple-pipe catheter tube and the expansion body are made of thermoplastic resin. 7. The vasodilator catheter according to any one of claims 1 to 6, wherein the hardness of the expander is smaller than the hardness of the triple-pipe catheter tube. 8. The vasodilator catheter according to any one of claims 1 to 7, wherein the outer surface of the outer tube, the outer surface of the expanded body, and the inner surface of the inner tube are subjected to hydrophilic treatment.
Priority Applications (8)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP61305385A JPS63158064A (en) | 1986-12-23 | 1986-12-23 | Blood vessel dilating catheter |
| PCT/JP1987/001013 WO1988004560A1 (en) | 1986-12-23 | 1987-12-22 | Vessel expanding catheter |
| US07/382,781 US4955895A (en) | 1986-12-23 | 1987-12-22 | Vasodilating catheter |
| AU10439/88A AU597774B2 (en) | 1986-12-23 | 1987-12-22 | Catheter |
| DE8888900132T DE3776915D1 (en) | 1986-12-23 | 1987-12-22 | VESSEL EXTENSION CATHETER. |
| EP88900132A EP0339093B1 (en) | 1986-12-23 | 1987-12-22 | Vessel expanding catheter |
| CA000555277A CA1289032C (en) | 1986-12-23 | 1987-12-23 | Vasodilating catheter |
| DK469888A DK469888D0 (en) | 1986-12-23 | 1988-08-22 | CARDUALDING CATS |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP61305385A JPS63158064A (en) | 1986-12-23 | 1986-12-23 | Blood vessel dilating catheter |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPS63158064A JPS63158064A (en) | 1988-07-01 |
| JPH0356068B2 true JPH0356068B2 (en) | 1991-08-27 |
Family
ID=17944483
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP61305385A Granted JPS63158064A (en) | 1986-12-23 | 1986-12-23 | Blood vessel dilating catheter |
Country Status (8)
| Country | Link |
|---|---|
| US (1) | US4955895A (en) |
| EP (1) | EP0339093B1 (en) |
| JP (1) | JPS63158064A (en) |
| AU (1) | AU597774B2 (en) |
| CA (1) | CA1289032C (en) |
| DE (1) | DE3776915D1 (en) |
| DK (1) | DK469888D0 (en) |
| WO (1) | WO1988004560A1 (en) |
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Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS5813859U (en) * | 1981-07-15 | 1983-01-28 | 新日本製鐵株式会社 | Continuous casting mold |
| JPS59177064A (en) * | 1983-03-29 | 1984-10-06 | テルモ株式会社 | Baloon catethel |
Family Cites Families (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US2936761A (en) * | 1958-04-25 | 1960-05-17 | Snyder Henry Howard | Catheter |
| US3547126A (en) * | 1968-02-15 | 1970-12-15 | Biomedical Eng Associates Inc | Catheter |
| CH616337A5 (en) * | 1977-10-21 | 1980-03-31 | Schneider Medintag Ag | |
| US4323071A (en) * | 1978-04-24 | 1982-04-06 | Advanced Catheter Systems, Inc. | Vascular guiding catheter assembly and vascular dilating catheter assembly and a combination thereof and methods of making the same |
| CA1257170A (en) * | 1984-10-31 | 1989-07-11 | Suha V. Ari | Rapidly inflatable balloon catheter and method |
| US4819751A (en) * | 1987-10-16 | 1989-04-11 | Baxter Travenol Laboratories, Inc. | Valvuloplasty catheter and method |
-
1986
- 1986-12-23 JP JP61305385A patent/JPS63158064A/en active Granted
-
1987
- 1987-12-22 AU AU10439/88A patent/AU597774B2/en not_active Ceased
- 1987-12-22 DE DE8888900132T patent/DE3776915D1/en not_active Expired - Fee Related
- 1987-12-22 US US07/382,781 patent/US4955895A/en not_active Expired - Fee Related
- 1987-12-22 EP EP88900132A patent/EP0339093B1/en not_active Expired
- 1987-12-22 WO PCT/JP1987/001013 patent/WO1988004560A1/en active IP Right Grant
- 1987-12-23 CA CA000555277A patent/CA1289032C/en not_active Expired - Fee Related
-
1988
- 1988-08-22 DK DK469888A patent/DK469888D0/en not_active Application Discontinuation
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS5813859U (en) * | 1981-07-15 | 1983-01-28 | 新日本製鐵株式会社 | Continuous casting mold |
| JPS59177064A (en) * | 1983-03-29 | 1984-10-06 | テルモ株式会社 | Baloon catethel |
Also Published As
| Publication number | Publication date |
|---|---|
| EP0339093B1 (en) | 1992-02-26 |
| DE3776915D1 (en) | 1992-04-02 |
| CA1289032C (en) | 1991-09-17 |
| US4955895A (en) | 1990-09-11 |
| EP0339093A1 (en) | 1989-11-02 |
| DK469888A (en) | 1988-08-22 |
| AU597774B2 (en) | 1990-06-07 |
| DK469888D0 (en) | 1988-08-22 |
| AU1043988A (en) | 1988-07-15 |
| WO1988004560A1 (en) | 1988-06-30 |
| EP0339093A4 (en) | 1989-11-07 |
| JPS63158064A (en) | 1988-07-01 |
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